Abstract
This is a retrospective study. As new surgical techniques and improved perioperative
care approaches have become available, the same-day discharge in selected total knee
arthroplasty (TKA) patients was introduced to decrease health care costs without compromising
outcomes. This study aimed to compare clinical and functional outcomes between same-day
discharge TKA patients and inpatient-discharge TKA patients. A retrospective review
of 100 consecutive patients with same-day discharge matched to a cohort of 300 patients
with inpatient discharge that underwent TKA by a single surgeon at a tertiary referral
center was conducted. Propensity-score matching was performed to adjust for baseline
differences in preoperative patient demographics, medical comorbidities, and patient-reported
outcome measures (PROMs) between both cohorts. All patients had a minimum of 1-year
follow-up (range: 1.2–2.8 years). In terms of clinical outcomes for the propensity
score-matched cohorts, there was no significant difference in terms of revision rates
(1.0 vs. 1.3%, p = 0.76), 90-day emergency department visits (3.0 vs. 3.3%, p = 0.35), 30-day readmission rates (1.0 vs. 1.3%, p = 0.45), and 90-day readmission rates (3.0 vs. 3.6%, p = 0.69). Patients with same-day discharge demonstrated significantly higher postoperative
PROM scores, at both 3-month and 1-year follow-up, for PROMIS-10 Physical Score (50
vs. 46, p = 0.028), PROMIS-10 Mental Score (56 vs. 53, p = 0.039), and Physical SF10A (57 vs. 52, p = 0.013). This study showed that patients with same-day discharge had similar clinical
outcomes and superior functional outcomes, when compared with patients that had a
standard inpatient protocol. This suggests that same-day discharge following TKA may
be a safe, viable option in selected total knee joint arthroplasty patients.
Keywords
total knee arthroplasty - same-day discharge - clinical outcomes - patient-reported
outcome measures
